Clinical, Histological and Cellular Evaluation of Vertico-Lateral Maxillary Reconstruction Associating Alveolar Osteogenic Distraction and Fresh-Frozen Bone Allograft

Clinical (a) and radiographic (b) aspects of vertico-lateral defect. Surgical exposure of the defect prior to osteotomies (c) and osteogenic distractor placement. Distractor activated and in position (d). Clinical aspect after 4 months prior to remove the distractor (e). Amount of vertical bone improvement (f). Clinical (g) and CT scan (h) aspects of residual lateral defect.

Clinical aspect of residual lateral defect (a). Fresh-frozen bone allograft (FFBA) settled with positional screws (b) and sutures (c). Clinical aspect 1 month after the grafting procedure, exhibiting lateral volume improvement (d).

Clinical aspect of graft after 6 months (a) and implants in position (b). Prosthetic rehabilitation restoring function and aesthetics (c,d). Periapical radiograph after 5 years (e). CT scan (coronal view) evidencing the profile maintenance 5 years after the grafting procedure (f).

Histological findings 5 years after grafting procedure. The presence of acellular areas (bone block) surrounded by new bone is noticed. Scale bar for a = 50 μm, b = 100 μm.

Proliferation at days 3, 7, and 10 of cells derived from autogenous bone (AB) and fresh-frozen bone allograft (FFBA) (a); ALP activity at 7, 10, and 14 days of cells derived from AB and FFBA (b); extracellular matrix mineralization at day 17 of cells derived from AB and FFBA (c). Bars with the same letter are not statistically significant different (P > 0.05).